Transfusion medicine and safety

ISBT Science Series, 2014

Testing blood donations for markers of infectious disease is critical to the maintenance of blood safety. The minimal expectation from WHO is that all donations should be tested for HIV, HBV, HCV and syphilis and that, in certain parts of the world, it may be appropriate to test for locally prevalent transfusion-transmissible infectious (TTI) agents. This article will review the rationale for selection of appropriate test methods and properties and will explain why there continues to be residual risk of transmission and how to estimate such risk.

Journal of Medical and Scientific Research, 2014

Blood transfusion, an integral part of medicine and surgery, also carries the risk of transfusiontransmissible infections like hepatitis B, hepatitis C, human immunodeficiency virus (HIV) 1 & 2, syphilis, malaria and infrequently toxoplasmosis, brucellosis & viral infections like cytomegalovirus (CMV), Epstein-Barr virus (EBV) and herpes [1] measuring their severity. World Health Organization (WHO) has recommended pre-transfusion blood test for HIV, hepatitis B (HBV), hepatitis C viruses (HCV), syphilis and malaria as mandatory [1]. All these diseases are capable of causing significant mortality, morbidity along with a financial burden for both the affected person and the country [2].

International Journal of Scientific Research, 2012

Transfusion transmitted infections (TTIs) can cause threat to bloody safety as blood transfusion is an important mode of transmission of TTI to the recipient, hence, to prevent transmission of these diseases, screening tests on blood bags is an important step for blood safety. This study was undertaken with the aim of determining the seroprevalence of TTI in healthy blood donors in a tertiary care blood bank. A retrospective study was carried out over a period of 5 years from January 2007 to December 2011. Serum samples were screened for hepatitis B surface antigen (HBsAg), antibodies to human immunodeficiency virus (HIV) Type 1 and 2, hepatitis c virus (HCV) and syphilis using enzyme-linked immunosorbent assays with the third generation kits and venereal disease research laboratory test, respectively. A total of 76,653 healthy donors were included out of which majority of donors were male (91.79%). The overall seroprevalence of HIV, HBsAg, HCV, and syphilis were 0.26%, 1.30%, 0.25%, and 0.28%, respectively. CONCLUSION: Methods to ensure a safety blood supply should be encouraged. For that, screening with a better selection of donors and use of sensitive screening tests including nucleic acid testing technology should be implemented.

Journal of Evolution of Medical and Dental Sciences

BACKGROUND Blood transfusion has hazards of Transfusion Transmissible Infections (TTI). Blood has several components whose separation, storage and utilization has brought down adverse reactions in recipients. This study aims at evaluating the prevalence of TTI in donors and the pattern of utilization of blood and its components in a tertiary care hospital. METHODS This is a retrospective descriptive study done between January to December 2017. Data regarding the screening of blood, component separation, storage, utilization and discarding was collected and analysed. RESULTS Out of 4158 donations screened, prevalence of TTI was 38 (0.9%) and that of HBV and HCV was 36 (0.86%) and 2 (0.04%). None of them were positive for HIV, Syphilis and Malaria. Total blood units collected were 10,184. PRBC (32.87%) was the most utilized component followed by FFP (30.59%), Platelet (26.18%), WB (10.33%) and Cryoprecipitate (0.04%). Obstetric (45.42%) cases were most benefited. Out of 143 units discarded, 84 units (58.74%) were discarded due to sero-positivity. CONCLUSIONS This study analyses the prevalence of TTIs in a tertiary care centre over a period of one year and also emphasizes the appropriate and judicious use of blood and blood components.

Sokoto Journal of Medical Laboratory Science, 2017

A transfusion transmitted infections (TTIs) is a potential pathogen (virus, bacteria or parasitic) that can be transmitted in donated blood through a blood transfusion to a recipient. The term is usually limited to known pathogens, but also sometimes includes agents such as Simian foamy virus which are not known to cause disease. TTIs Constitute great public epidemic hence preventing the spread of these diseases especially HIV by blood transfusion should be addressed in several ways. In many cases, the blood is tested for the pathogen, sometimes with several different methodologies. Donors of blood are also screened for signs and symptoms of disease and for activities that might put them at risk for infection. Being able to detect new HIV infections earlier is not only beneficial to people seeking testing and to the service providers offering testing services, but may also play a significant role in preventing further transmission of HIV within the population. Lack of p24 and HIV NAT test at different health facility at both urban and rural area is a great health concern in blood safety. If a local supply is not safe, blood may be imported from other areas.

Archives of pathology & laboratory medicine, 2007

Infectious disease testing has dramatically improved the safety of blood for transfusion in the United States, especially since the introduction in 1999 of nucleic acid amplification testing. In 2004, methods (primarily culturing) for detecting bacteria in platelets were also added. To provide current risk estimates for the likelihood of viral transmission by test-negative blood components and to illustrate the safety improvements since the introduction of bacterial testing of platelets. Published literature from 1999 through 2006 and unpublished American Red Cross data sources. The risk of human immunodeficiency virus and hepatitis C virus transmission through blood transfusion since the introduction of nucleic acid amplification testing is approximately 1 in 2 million. Hepatitis B virus risk, for which nucleic acid amplification testing is not performed routinely, remains at 1 in 200,000 to 500,000 using a combination of anti-hepatitis B core and hepatitis B surface antigen testin...

JAMA: The Journal of the American Medical Association, 1995

Objective. To provide physicians and other transfusion medicine professionals with a current consensus on infectious disease testing for blood transfusions. Participants. A non-Federal, nonadvocate, 12-member consensus panel representing the fields of hematology, infectious disease, transfusion medicine, epidemiology, and biostatistics and a public representative. In addition, 23 experts in hematology, cardiology, transfusion medicine, infectious disease, and epidemiology presented data to the consensus panel and a conference audience of 450. Evidence. The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts pre pared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. Consensus. The panel, answering predefined consen sus questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. Consensus Statement. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the confer ence. The panel finalized the revisions within a few weeks after the conference. Conclusions. The serum alanine aminotransferase test should be discontinued as a surrogate marker for blood donors likely to transmit posttransfusion non-A, non-B hepatitis infection since specific hepatitis C anti-body testing has eliminated more than 85 percent of these cases. Anti-hepatitis B core antigen testing should continue as it may prevent some cases of posttransfusion hepatitis B; it also may act as a surrogate marker for HIV infection in donors and may prevent a small number of cases of trans fusion-transmitted HIV infection. Syphilis testing should continue until adequate data can determine its effect on the rarity of transfusion-transmitted syphilis. Vigilant public health surveillance is critical in responding to emerging infectious disease threats to the blood supply.

BMJ, 1990

Journal of Evidence Based Medicine and Healthcare

BACKGROUND Blood transfusion carries the potential risk of transfusion transmissible infections (TTIs) making it the most dreaded complication of blood transfusion. The objective was to study the trends in seroprevalence of HIV, HBV, HCV, Syphilis and Malaria amongst the blood donors. METHODS Study was done over a period of 5 years. Blood donors' data was collected from the blood bank of our institution. Serum samples were tested for HIV-antibody, HCV-antibody and HBsAg using ELISA and Malarial parasite antigen and syphilitic anticardiolipin antibodies by rapid diagnostic tests (RDT). RESULTS During the study, a total of 20584 blood donors were screened, out of which 369 blood units were found to be seropositive accounting for a seroprevalence of 1.8%. Seroprevalence of HIV, HBV, HCV, Syphilis and Malaria were 0.20%, 1.34%, 0.22%, 0.06% and 0% respectively. Out of total screened donors, voluntary donors were 79.4% and remaining 20.6% were replacement donors. An overall decreasing trend was noted in seroprevalence of TTIs over the past five years (p<0.05). Individually, HIV and HCV which showed statistically significant decreasing trend (p<0.05) while HBV continued to show higher seroprevalence. CONCLUSIONS The prevalence of TTIs has decreased considerably after mandatory testing of blood Units for TTIs. Strict guidelines and their implementation for donor selection and their screening using sensitive tests is the need of the hour in order to reduce the incidence of TTIs.

New England Journal of Medicine, 1996

Background. Accurate estimates of the risk of transfusion-transmitted infectious disease are essential for monitoring the safety of the blood supply and evaluating the potential effect of new screening tests. We estimated the risk of transmitting the human immunodeficiency virus (HIV), the human T-cell lymphotropic virus (HTLV), the hepatitis C virus (HCV), and the hepatitis B virus (HBV) from screened blood units donated during the window period following a recent, undetected infection.